DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Patrick, George D	DOIID	600139	NAIC NPN	2404888

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	12/20/2004	1/31/2009
Inactive	Non Resident	Agent	Property	12/20/2004	1/31/2009
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Amerisure Insurance Company	300298	Agent - Casualty	7/5/2005	10/31/2008
Inactive	Amerisure Insurance Company	300298	Agent - Property	7/5/2005	10/31/2008
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Casualty	7/5/2005	10/31/2008
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Property	7/5/2005	10/31/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	7/18/2005	4/29/2008
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	7/18/2005	4/29/2008